High-Precision Surgical Robotic System for Intraocular Procedures

Abstract--Despite the extensive demonstration of robotic systems for both cataract and vitreoretinal procedures, existing technologies or mechanisms still possess insufficient accuracy, precision, and degrees of freedom for instrument manipulation or potentially automated tool exchange during surgical procedures. A new robotic system that focuses on improving tooltip accuracy, tracking performance, and smooth instrument exchange mechanism is therefore designed and manufactured. Its tooltip accuracy, precision, and mechanical capability of maintaining small incision through remote center of motion were externally evaluated using an optical coherence tomography (OCT) system. Through robot calibration and precise coordinate registration, the accuracy of tooltip positioning was measured to be 0.053 0.031 mm, and the overall performance was demonstrated on an OCT - guided automated cataract lens extraction procedure with deep learning-based pre-operative anatomical modeling and real-time supervision. Surgical robots have demonstrated success in improving the safety and efficiency of surgical procedures in recent decades [1]. Intraocular procedures often require high precision and delicate manipulation to reduce surgical complications, but some procedures remain infeasible to humans due to physiological limitations [2], left alone retinal vein cannulation that is too risky to be performed by human surgeons [3]. Even experienced surgeons include an average hand tremor of 200 to 350 µm relative to vein diameters of 120 to 200 µm, as well as the inability to perceive the small manipulating forces associated with piercing veins [4], [5]. As a result, surgical robots become good candidates for this type of sophisticated tissue manipulation.